Diagnosis and Treatment: Getting it Right

When 11-year-old Samuel* was readmitted to the hospital with a history of soft-tissue infection and escalating symptoms, test results didn’t look good: infection had spread to his right tibia. After IV antibiotics didn’t work and serious complications continued to intensify, the recommendation was a below-the-knee amputation.

diagnostic errorThat’s when Best Doctors experts were called in to give a second opinion. After a careful review of Samuel’s symptoms, medical records, and test results, there was no change to the diagnosis. But the experts identified an alternative to amputation. Why not try a different antibiotic that was known for better absorption by the bone, plus some strategic, regular lab work, treatment, and tests for up to six months?

As it turned out, Samuel responded well to the new treatment plan and was able to avoid a life-altering amputation—not to mention all of the medical bills for a prosthesis and rehab.

Even with the best intentions, careful examinations and diligent research, sometimes doctors get it wrong. In fact, research reveals some startling information about the prevalence and consequences of diagnostic error:

  • 40,000 – 80,000 deaths in the United States each year are blamed on diagnostic error.[1]
  • 10-15% of all diagnoses are missed, wrong or delayed.[2]
  • 1 in 20 patients receive a diagnostic error each year.[3]
    • More than half of these errors occur in ambulatory care settings.
    • 28% happen in inpatient hospital settings.
    • 16% happen in the pressure-filled environment of the emergency room.
  • Primary care physicians and internists misdiagnose 13% of cases where a chronic condition exists.[4]

Getting the right diagnosis and treatment plan is critical for everyone. For the patient, nothing can compare to having peace of mind, quality care and, of course, the best possible outcome. For doctors and health plans, it’s crucial to know that patients are receiving excellent care, and it’s important to ensure quality while also controlling costs.

“I am so grateful to have had access to such a program,” Samuel’s dad said. “The guidance that both experts provided definitely gave my wife and I confidence knowing that our son was getting the most appropriate care.”

For more facts about diagnostic error and what Best Doctors is doing to confront the problem, download our new white paper here.

*The patient’s name was changed to protect his privacy.

[1] Leape LL. Counting deaths due to medical errors. JAMA. 2002;288:2404-05.

[2] Elstein A. Clinical reasoning in medicine. In: Higgs J, ed. Clinical reasoning in the health professions. Oxford, England: Butterworth-Heinemann Ltd. 1995;49–59.

[3] Singh H, Meyer AND, Thomas EJ. The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Qual Saf. 2014; 0:1-5.

[4] Peabody JW, Luck J, Jain S, et al. Assessing the accuracy of administrative data in health information systems. MedCare. 2004;42:1066–72.

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